中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (07): 482-485.doi: 10.3969/j.issn.1671-4091.2019.07.005

• 临床研究 • 上一篇    下一篇

透析间期动态血压与透析日血压的相关性研究

李成1.2,甘良英1,杨冰1,赵新菊1,王磊1,蔡美顺1,左力1   

  1. 1北京大学人民医院肾内科
    2九江学院附属医院肾内科

  • 收稿日期:2018-11-26 修回日期:2019-04-23 出版日期:2019-07-12 发布日期:2019-07-12
  • 通讯作者: 甘良英gan@bjmu.edu.cn E-mail:gan@bjmu.edu.cn
  • 基金资助:
    北京市科学技术委员会首都临床特色应用研究支持项目(Z131107002213122)

The correlation between interdialytic ambulatory blood pressure and intradialytic blood pressure

  1. 1Departmentof Nephrology, Peking University People’s Hospital, Beijing 100044, China;  2Department of Nephrology, Affiliated Hospital of Jiujiang University, Jiujiang 332000, China
  • Received:2018-11-26 Revised:2019-04-23 Online:2019-07-12 Published:2019-07-12

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摘要：

【摘要】目的明确维持性血液透析(maintenance hemodialysis，MHD)患者透析间期动态血压(ambulatory blood pressure monitoring，ABPM)的情况及其与透析日血压的相关性。方法选取2014 年12月～2017 年12 月在北京大学人民医院接受MHD 治疗患者51 例，分别采集患者透析间期44hABPM 值及该周3 个透析日透析前、透析中及透析结束后血压数值。采用配对样本t 检验比较透析间期与透析日血压，采用Pearson 相关性分析衡量透析间期ABPM 值和透析日各时段血压测量值之间的相关性，通Blandaltman
分析对这2 种测量方法进行一致性检验。结果透析间期ABPM 值与透析日血压值之间存在差异(t＝-3.854，P＜0.001)。透析间期收缩压与透析前、透析中及透析后收缩压之间存在较弱的相关性(r值分别为0.381，0.442，0.374；P 值分别为0.007，0.001，＜0.001)，其中以透析间期44h 收缩压与透析中收缩压的关系较为显著。Bland-altman 分析显示透析间期44h 收缩压与透析中收缩压差值的95% CI 为(-32.42，35.64)mmHg(1mmHg=0.1333kpa)。结论患者透析间期血压与透析日血压水平存在差异，透析日血压不能取代ABPM用于评估MHD 患者透析间期的血压水平。

关键词: 动态血压, 血液透析, 透析日血压

Abstract:

【Abstract】Objective To determine the situation of interdialytic ambulatory blood pressure monitoring(ABPM) and its correlation with intradialytic blood pressure (BP) in maintenance hemodialysis (MHD) patients. Methods Fifty-one MHD patients treated in Peking University People’s Hospital from Dec. 2014 to Dec. 2017 were recruited. Their interdialytic ABPM values for 44 hours and the BP values before, during and after dialysis for 3 sessions in this week were collected. Paired sample t test was used to compare interdialytic BP values and the BP values in the dialysis day. Pearson correlation analysis was used to evaluate the correlation between interdialytic ABPM values and BP values at different stages in the dialysis day. Bland-altman difference method was used to test the consistency of the two measurement methods. Results There was a difference between interdialytic ABPM values and the BP values in the dialysis day (t＝- 3.854, P＜0.001). There were weak correlations of interdialytic systolic BP (SBP) with the SBP before (r＝0.381, P＝0.007), during (r＝0.442, P＝0.001) and after dialysis (r＝0.374, P＜0.001) in the dialysis day, in which significant relationship was present between interdialytic 44 hours SBP and the SBP during dialysis. Bland-Altman analysis showed that the 95% confidence interval for the difference between interdialytic 44 hours SBP and the SBP during dialysis was -32.42, 35.64 mmHg. Conclusion Interdialytic BP was different from the BP in the dialysis day. BP in the dialysis day cannot replace ABPM for evaluating interdialytic BP in MHD patients.

Key words: Ambulatory blood pressure, Hemodialysis, Intradialytic blood pressure

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